The validity of recognition of stroke in the emergency room (ROSIER) scale in the diagnosis of Iranian patients with acute ischemic stroke in the emergency department
Mahdi Zangi1
, Somayeh Karimi2, Sahar Mirbaha3, Mehran Sotoodehnia2, Fatemeh Rasooli2, Alireza Baratloo4
1Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
2Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
3Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4Prehospital and Hospital Emergency Research Center; Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Decision support techniques, emergency service, hospital, stroke
Abstract
OBJECTIVES: In this study, we aimed to investigate the accuracy of recognition of stroke in the Emergency Room (ROSIER) Scale in the diagnosis of patients with acute ischemic stroke (AIS) transferred to the emergency department (ED).
METHODS: The present study was a multicenter study. Records from patients suspected of stroke, who referred to the ED were reviewed. Demographic, clinical, and diagnostic data were extracted and then entered in checklists. ROSIER Scale was used to evaluate the possible diagnosis in this study. The definitive diagnosis of a stroke was made based on neurologist's assessment and clinical and neuroimaging findings, mainly brain magnetic resonance imaging (MRI). Receiver operating characteristic (ROC) curve analysis was conducted for assessing the accuracy of ROSIER in discrimination of stroke.
RESULTS: The data of 356 suspected stroke patients were analyzed. Of all, 186 patients (52.2%) were male, and the mean age was 65.2 (standard deviation = 14.0) years ranging from 26 to 95 years. One hundred and fifty-one patients (42.4%) had AIS based on the final diagnosis. The area under the ROC curve was 0.85. The best cutoff point for ROSIER scale was ≥1 with a sensitivity of 85.4% (95% confidence interval [CI]: 78.8, 90.6%) and specificity of 65.8% (95% CI: 58.9, 72.3%).
CONCLUSION: Based on the findings, although the best cutoff point was the same as the original (derivation) study, its sensitivity (85.4% vs. 92%) and specificity (65.8% vs. 86%) were considerably lower.
How to cite this article: Zangi M, Karimi S, Mirbaha S, Sotoodehnia M, Rasooli F, Baratloo A. The validity of recognition of stroke in the emergency room (ROSIER) scale in the diagnosis of Iranian patients with acute ischemic stroke in the emergency department. Turk J Emerg Med 2021;21:1-5
Tehran University of Medical Sciences, No: IR.TUMS.MEDICINE.REC.1397.245, Date: 21.07.2018.
The conception and design of the work by AB, SK and FR; Data acquisition by SK, SM, and MS; Analysis and interpretation of data by MZ, FR and AB; Drafting the work by MS, MZ, and SK; Revising it critically for important intellectual content by AB, SM, and FR; All the authors approved the final version to be published; And agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work.
None Declared.
The study was supported with a grant received from the Vice Chancellor for Research, TUMS (97-03-30-38950).
This study was conducted with the support of the Prehospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran. The present article was extracted from the thesis by Dr. Mahdi Zangi to achieve his specialist degree in emergency medicine from the Tehran University of Medical Sciences.